Importance of Catheter Contact Force During Irrigated Radiofrequency Ablation: Evaluation in a Porcine <i>Ex Vivo</i> Model Using a Force‐Sensing Catheter

Thiagalingam, Aravinda; d’Ávila, André; Foley, Lori; Guerrero, J. Luis; Lambert, Hendrik; Leo, Giovanni Di; Ruskin, Jeremy N.; Reddy, Vivek Y.

doi:10.1111/j.1540-8167.2009.01693.x

Cited by 249 publications

(224 citation statements)

References 19 publications

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“…16 Additionally, impedance monitoring has an additional important role for monitoring safety of RF energy application, as steam pops are rarely seen when the impedance decrease is less than 15 ohms (O). 13,17 Clinical data have supported the utility of performing PVI guided by close impedance monitoring with a standard RF ablation catheter (non-contact force-sensing). By ensuring an impedance decrease of at least 5 O in the first 10 s of ablation, 84% of patients with paroxysmal AF remained free of demonstrable recurrent atrial arrhythmias after 431 ± 87 days.…”

Section: Rf Lesion Assessmentmentioning

confidence: 99%

“…18 As contact force is an important factor in lesion creation, increased catheter-tissue contact has now been associated with a larger impedance decrease during RF ablation, 12,17,19 and in the absence of sufficient catheter-tissue contact, an impedance decrease of 10 O cannot be achieved. 12 However, contact force is only one of several factors associated with lesion creation (ablation power, duration, surface area, catheter stability and tip-to-tissue contact, and local tissue resistance being other examples) and, when measured in isolation, does not indicate effective tissue destruction.…”

Section: Role Of Contact Forcementioning

confidence: 99%

See 1 more Smart Citation

Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes

Chinitz

Michaud

Stephenson

2017

J Innov Cardiac Rhythm Manage

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ABSTRACT. Despite the achievement of acute conduction block during catheter ablation, the recovery of conduction at previously ablated sites remains a primary factor implicated in arrhythmia recurrence after initial ablation. Real-time markers of adequate ablation lesion creation are needed to ensure durable ablation success. However, the assessment of acute lesion formation is challenging, and requires interpretation of surrogate markers of lesion creation that are frequently unreliable. Careful monitoring of impedance changes during radiofrequency catheter ablation has emerged as a highly specific marker of local tissue destruction. Ablation strategies guided by close impedance monitoring during ablation applications have been demonstrated to achieve high levels of success for ablation of atrial fibrillation. Impedance decrease during ablation may therefore be used as an additional endpoint beyond acute conduction block, in order to improve the durability of ablation lesions. In this manuscript, available methods of real-time lesion assessment are reviewed, and the rationale and technique for impedance-guided ablation are described.

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Section: Rf Lesion Assessmentmentioning

confidence: 99%

Section: Role Of Contact Forcementioning

confidence: 99%

Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes

Chinitz

Michaud

Stephenson

2017

J Innov Cardiac Rhythm Manage

View full text Add to dashboard Cite

show abstract

“…The difficulty of directly assessing the degree and quality of contact between the catheter tip and the target tissue has been demonstrated even in experienced operators 2. Moreover, preclinical research has shown that insufficient CF can result in ineffective lesion formation 5, 6, 7. Therefore, poorer clinical outcome can occur even if tactile feedback, fluoroscopy, and high‐amplitude electrograms appear to indicate good contact 2.…”

Section: Discussionmentioning

confidence: 99%

Ablation of recurrent malignant idiopathic ventricular tachycardia: When proper diagnosis and success is a matter of contact

Giaccardi

Mascia²,

Perini

et al. 2018

Clinical Case Reports

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“…A number of studies have convincingly demonstrated that catheter contact force correlates with the delivery of effective ablation lesions and durable PV isolation. [9][10][11][12] Further, clinical outcomes have been reported to be superior in patients undergoing AF ablation with contact force catheters as compared with conventional ablation catheters. 13 The two main contact force catheters currently in use for AF ablation are the ThermoCool © SmartTOUCH™ catheter (Biosense Webster, CA, USA) and the TactiCath™ catheter (Endosense, Inc., Geneva, Switzerland).…”

Section: Advances In Catheter Design For Af Ablationmentioning

confidence: 99%

New Ablation Technologies and Techniques

Mahida

Berte

Yamashita

et al. 2014

Arrhythmia &Amp; Electrophysiology Review

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Since the first catheter ablation for cardiac arrhythmia more than three decades ago, ablation technology has continually evolved at a rapid pace. Much of the early progress in the field was made in ablation of supraventricular tachycardias. Following a seminal study from Haïssaguerre et al. 1 in 1998, which demonstrated that pulmonary vein triggers are important sources of atrial fibrillation (AF), the approach to management of AF underwent a revolution. Electrical isolation of pulmonary veins (PVs) using catheter ablation became an established therapeutic strategy in patients with paroxysmal AF. During subsequent years, the role of ablation in AF expanded, and more extensive strategies involving ablation of non-pulmonary vein triggers and modification of the left atrial substrate were demonstrated to be effective, even in persistent forms of AF. New Technologies and Techniques for AF AblationCurrently, the most widely used technique for PV isolation involves delivery of point-by-point ablation lesions around the circumference of the vein. A number of different variations to the approach have been developed. During the early stages of PV isolation, a 'segmental approach' which involved targeting the earliest PV potentials at the ostium of the PV was commonly used. Due to high reconnection rates and the risk of PV stenosis, the technique has progressively been modified and the prevailing technique involves circumferential antral ablation to achieve PV isolation. AbstractCatheter ablation is an established treatment strategy for a range of different cardiac arrhythmias. Over the past decade two major areas of expansion have been ablation of atrial fibrillation (AF) and ventricular tachycardia (VT) in the context of structurally abnormal hearts. In parallel with the expanding role of catheter ablation for AF and VT, multiple novel technologies have been developed which aim to increase safety and procedural success. Areas of development include novel catheter designs, novel navigation technologies and higher resolution imaging techniques. The aim of the present review is to provide an overview of novel developments in AF ablation and VT ablation in patients with of structural cardiac diseases.

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Importance of Catheter Contact Force During Irrigated Radiofrequency Ablation: Evaluation in a Porcine Ex Vivo Model Using a Force‐Sensing Catheter

Abstract: Catheter contact force has an important impact on both ablation lesion size and the incidence of pops.

Cited by 249 publications

References 19 publications

Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes

Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes

Ablation of recurrent malignant idiopathic ventricular tachycardia: When proper diagnosis and success is a matter of contact

New Ablation Technologies and Techniques

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